And Now a Word from Our Experts
Over the past few weeks, we’ve been discussing the keto diet. We’ve talked about what the diet is, what it’s based on, what macronutrients are, etc. To wrap up this series, in this blog we’ll discuss what the experts have to say about this diet, its procs and cons, its dangers and its benefits.
What Physicians Say
In researching what medical professionals have to say about the keto diet I found the following breakdown:
Dr. Nancy Rahnama, a board-certified internist who specializes in nutritional health says the keto diet can be a very successful way of losing weight rapidly as long as it’s gone about in a safe way. 
According to Dr. Josephine, chief of the nutrition division and a known expert in the nutritional management of obesity and chronic illnesses, there is some evidence that a keto diet can be effective for patients with epilepsy. This is because the keto diet is especially effective in decreasing seizure activity in people with epilepsy. 
Tiffany Lester, MD, an integrative-medicine doctor and Medical Director of Parsley Health in San Francisco, Calif., tracks the following biomarkers in her patients who are on the keto diet:
- Comprehensive metabolic panel
- Complete cholesterol profile
- Thyroid hormones – TSH, FT4, FT3
- Sex hormones – estrogen, progesterone and testosterone 
Medical expert, Dr. Ryan Light with TPMG (family medicine) states the keto diet is safe for most people. The keto diet has been shown to be helpful with weight loss and lowering cholesterol levels. In diabetics, the keto diet has been shown to help reduce medication usage and glucose variablity.
Dr. Light also says the keto diet not only lowers bad cholesterol levels but can increase the levels of good cholesterol. 
Dr. Amnon Beniaminovitz, a board-certified cardiologist, cautions some people can feel unwell when starting the diet. This phenomenon is referred to as the “keto flu.” This means symptoms such as headaches, fatigue, dizziness, nausea, brain fog, and irritability. 
Dr. Nicole Harkin, a board-certified cardiologist and lipidologist, states that since the keto diet includes high intakes of animal products, which contain a lot of saturated fats and animal proteins, LDL cholesterol levels tend to be higher. This is a consistent risk factor for the onset of cardiovascular disease. 
Dr. Ryan Light points out that long-term weight loss is only possible with lifestyle changes. Fad diets can result in weight loss but this loss is not long-term. Weight loss effected by the diet is usually limited to 13-17 pounds. The lowering of bad cholesterol levels on the keto diet is short-lived. The cholesterol benefits lasts around 12 months after which the body adapts and returns to its original cholesterol levels. The weight loss generally shows no weight loss after about 2 years. The only true way to lose weight and keep it off is by limiting caloric intakes and increasing cardiovascular exercise (30 minutes a day, 5 times a week). 
What Nutritionist Professionals Say
Kristin Kirkpatrick, a registered dietician and Lose It! nutrition expert from Denver, has tried the keto plan herself, so that she knows firsthand what some of her clients are experiencing. According to her, the “keto flu” is real, but you need to stick with the diet to see results. “The beginning of the keto plan can be overwhelming,” Kirkpatrick said. “Hangry doesn’t even begin to describe it. But once your body gets used to a low glucose supply, there’s almost a sense of euphoria.” 
Evan Jensen, renowned American Nutritionist, diet expert and health writer, gives the following pros for the keto diet:
- Fat Burning
- Excretion of Ketones
- Protein Sparing Effect
- Lowered Insulin Levels
- Decreased Appetite 
Ginger Hultin, a registered dietitian, nutritionist and Arivale coach, states that despite results suggesting successful short-term weight loss, the keto philosophy lacks strong scientific research on the diet’s long-term effects. 
Ms. Hultin also points out that there is a possibility of kidney damage, nutritional deficiencies, and side effects including constipation, dehydration, fatigue and nausea with this diet. Individuals and their health care professionals should weigh the advantages and disadvantages. 
Nutritionist Evan Jensen cautions that the keto diet can trigger fatigue and brain fog, an altered blood lipid profile, micronutrients deficiencies and ketoacidosis. 
What the Research Says
The ketogenic diet with long-term use has been shown to cause kidney stones and osteoporosis. There is conflicting research with regard to the diet`s long term cardiovascular risks. In children, the ketogenic diet has been shown to impair growth and is only indicated in severe cases of epilepsy. 
There is research that supports that the keto diet may also be beneficial to patients with diabetes, cancer, and Alzheimer’s disease. 
Some studies have also shown that the keto diet is safe for significantly obese or overweight people. 
There have been studies, like the Essentials of Exercise Physiology (McArdle, WD, Philadelphia, PA Lea & Febiger, 1994), that speculate that ketosis can put undue stress on the kidneys, although few clinical studies have actually shown this damage. 
In perhaps the highest protein intake ever studied, an adult male bodybuilder consumed an average of 2,263 calories, 71% from protein or 2.27 grams per pound for 10 weeks. His weight dropped from 168 lbs. to 139 lbs. and his body fat from 16% to 4.4%. Blood analysis found an increase in a reliable test of kidney function called “blood urea nitrogen” or BUN from 16 to 53 (normal is 6 to 25) without evidence of kidney damage. 
Research from 2014 published by the International Journal of Environmental Research and Public Health shows that “the ketogenic diet can be a useful tool to treat obesity in the hands of the physician.” The key here is that a doctor should be monitoring the process to avoid potential problems.
New research has come out about the negative health effects of carbs in regard to increasing obesity rates, and many studies have found that a higher-fat diet may actually be more protective against heart disease than many medical professionals previously thought. 
As SplitFit stresses to everyone, everyone’s body is different. This means the needs of each body are different, each body’s reasonable fitness goals are different, as are the methods and reasonable expectations of meeting those goals. There are the good tried and true methods of losing weight and getting in shape, such as a basic diet with the recommended percentages of nutrients, regular exercise with both cardio and strengthening exercises, lifestyle changes such as cessation of smoking and heavy alcohol use. Outside of the basic, balanced diet, other diets come and go. The keto diet, as we’ve seen, has plenty of pros and cons, plenty of dos and don’ts, plenty of success and failure stories.
As always, do your research, get your facts, know the pros and cons, and never start any diet or exercise regimen without consulting with your doctor, nutritionist, or other healthcare professional.
Image Credit: Consumer Health Digest